OFFICIAL ENTRY FORM – PLEASE PRINT
Please Print All Requested Information:
Name________________________________________Telephone___________________________ Age_____
Street_____________________________________ City____________________ State ____ ZIP __________
E-mail (we do not distribute this info) _________________________
Circle One:
Gender: M F Adult t-shirt size: S M L XL
| Cost: $19 by 3/08/08. Late and race day registration will be $24. |
| Waiver: I know that running a road race is a potentially hazardous activity. I am in proper physical condition to compete in this run/walk and assume all risks associated with my participation, including but not limited to falls, contact with other participants, the effects of the weather including high heat and/or humidity, traffic, and the conditions of the road, all such risks being known and appreciated by me. I will not wear head sets or any device that restricts my hearing or other perception. Inconsideration of this entry, for myself and anyone entitled to act on my behalf, I waive and release all race officials, volunteers, sponsors, and any others associated with this event from legal liability. Furthermore, I hereby grant the agents of this event permission to use photographs, videotapes, motion pictures, recording or other record of use in this event for legitimate purposes. |
Signature ______________________________________________
Parent/Guardian if under 18 _________________________________
Mail
form and
make checks payable to:
Americans4Fitness
978 Scott Circle
Decatur, GA 30033